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Chatziralli I.P.,Veroia General Hospital | Sergentanis T.N.,National and Kapodistrian University of Athens
Ophthalmology | Year: 2011

Purpose: To evaluate risk factors (hypertension, diabetes mellitus, and current tamsulosin, alfuzosin, terazosin, or doxazosin use) for intraoperative floppy iris syndrome (IFIS) in patients undergoing phacoemulsification cataract surgery. Design: Systematic review and meta-analysis of the literature. Participants: Seventeen eligible studies (17 588 eyes) examining the association between IFIS and risk factors. Methods: Pertinent publications were identified through a systematic search of PubMed. All references of relevant reviews and eligible articles were also screened. Language restrictions were not used, and data were extracted from each eligible study by 2 investigators working independently. For medications, 2 separate analyses were performed: an analysis using a dichotomous criterion (use/non-use of the examined agent) and an alternative analysis performing comparisons with patients not receiving any α1-blocker. The fixed-effects model (Mantel-Haenszel method) or the random-effects (DerSimonian Laird) model was appropriately used to calculate the pooled odds ratio (OR). Publication bias was appropriately assessed. Main Outcome Measures: Pooled OR for the incidence of IFIS. Results: The pooled OR for IFIS after tamsulosin use was approximately 40-fold greater (or 16.5 at the alternative analysis) than that after alfuzosin use, that is, the second α1-blocker in order of effect size. Alfuzosin and terazosin were also associated with IFIS with comparable ORs; the effect of doxazosin reached formal statistical significance at the alternative analysis. Intraoperative floppy iris syndrome was positively associated with hypertension (pooled OR = 2.2, 95% confidence interval [CI], 1.2-4.2, fixed effects) but not with diabetes mellitus (pooled OR = 1.3, 95% CI, 0.7-2.2, fixed effects). Conclusions: This meta-analysis has highlighted a hierarchy concerning the role of α1-blockers in IFIS, indicating an extremely sizeable effect size of tamsulosin; this may entail important physiologic implications. Alfuzosin, terazosin, and doxazosin presented with comparable effect sizes. Hypertension, but not diabetes mellitus, emerged as a risk factor for IFIS. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2011 American Academy of Ophthalmology. Source


Kourkoulos M.,Royal Infirmary | Giorgakis E.,Royal London Hospital | Kokkinos C.,Veroia General Hospital | Mavromatis T.,Evangelismos General Hospital | And 3 more authors.
Minimally Invasive Surgery | Year: 2012

Introduction. Laparoscopic greater curvature plication is an operation that is gaining ground in the treatment of morbid obesity, as it appears to replicate the results of laparoscopic sleeve gastrectomy with fewer complications. Aim. Review of current literature, especially results on weight loss and complications. Method. 11 (eleven) published articles on laparoscopic gastric plication, of which 1 preclinical study, 8 prospective studies for a total of 521 patients and 2 case reports of unusual complications. Results. Reported Paracentage of EWL in all studies is comparable to Laparoscopic Sleeve Gastrectomy (around 50% in 6 months, 60-65% in 12 months, 60-65% in 24 months) and total complication rate is at 15,1% with minor complications in 10,7%, major complications in 4,4%. Reoperation rate was 3%, conversion rate was 0,2%, and mortality was zero. Conclusion. Current literature on gastric plication and its modifications is limited and sketchy at times. Low cost, short hospital stay, absence of prosthetic material, and reversibility make it an attractive option. Initial data show that LGCP is effective for short- and medium-term weight loss, complication and reoperation rates are low, and GERD symptoms are unaffected. More data is required, and randomized control trials must be completed in order to reach safe conclusions. © 2012 Michael Kourkoulos et al. Source


Chatziralli I.P.,Veroia General Hospital | Papazisis L.,Veroia General Hospital | Sergentanis T.N.,National and Kapodistrian University of Athens
Ophthalmologica | Year: 2011

Background/Aims: To evaluate the benefit of adding a nonsteroid agent to an antibiotic/steroid combination after uneventful phacoemulsification, adopting a weekly follow-up, to gain insight into the optimal duration of postoperative treatment and to examine whether risk factors for inflammation exist. Methods: Patients were randomized to (i) tobramycin 0.3%-dexamethasone 0.1%, 1 drop q.i.d. (n = 72), and (ii) a combination of tobramycin 0.3%-dexamethasone 0.1%, 1 drop q.i.d., plus ketorolac tromethamine 0.5%, 1 drop t.i.d. (n = 73). On days 7, 14, 21 and 28, the frequency of inflammation-related signs (corneal edema, conjunctival hyperemia, anterior chamber or Tyndall reaction) as well as best-corrected visual acuity (BCVA) were measured. On day 21, logistic regression was performed to evaluate risk factors for inflammation. Results: The frequency of inflammation-related signs did not differ between the 2 groups at any time point, neither did BCVA. On day 21, pseudoexfoliation was associated with the presence of any inflammation-related sign (OR = 4.5; 95% CI: 1.2-16.0; p = 0.022). No evidence of clinically significant cystoid macular edema became evident in either group. Conclusion: The addition of ketorolac did not seem to offer any additional benefit in terms of inflammation-related signs. Four weeks appeared as an adequate treatment interval. Special attention should be paid to patients with pseudoexfoliation. Copyright © 2010 S. Karger AG, Basel. Source


Chatziralli I.P.,Veroia General Hospital | Papazisis L.,Veroia General Hospital | Sergentanis T.N.,National and Kapodistrian University of Athens
International Ophthalmology | Year: 2014

Gardner's syndrome (GS) is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with osseous tumors and soft-tissue tumors, such as epidermoid cysts and lipomas. An osteoma is a benign, osteogenic tumor and may be sporadic or related to GS. Here, we present a patient with a giant sino-orbital osteoma and blepharoptosis as the only symptom of incomplete GS. A 74-year-old woman, with no previous history of trauma or ophthalmic surgery, presented with a 2 years history of right blepharoptosis without diplopia. The results of slit-lamp and fundoscopic examination were normal. Computed tomography showed a giant sino-orbital osteoma. With suspicion for GS, we thoroughly examined the patient and found no soft-tissue tumors. Fifteen years ago, the patient, who had a family history of colonic polyposis, underwent right colectomy and chemotherapy for adenocarcinoma. We report a case of incomplete GS with blepharoptosis as the first symptom. © 2013 Springer Science+Business Media Dordrecht. Source


Chatziralli I.P.,Veroia General Hospital | Sergentanis T.N.,National and Kapodistrian University of Athens | Keryttopoulos P.,Veroia General Hospital | Vatkalis N.,Veroia General Hospital | And 2 more authors.
BMC Research Notes | Year: 2010

Background. Diabetes mellitus (DM) is associated with microvascular complications, such as diabetic retinopathy (DR). DR is one of the main causes of visual loss in individuals aged 20-64 years old. This study aims to investigate the independent associations between the stage of DR and a variety of possible risk factors, including years since DM diagnosis, HbA 1clevels, the coexistence of hypertension, age and gender. Findings. 120 patients were recruited in the Department of Internal Medicine, Veroia General Hospital, Veroia, Greece, and the DR stage was defined by an ophthalmologist. Afterwards, the DR association with the aforementioned factors was examined. Univariate and multivariate analysis (multivariate ordinal logistic regression) was performed. At the univariate analysis, there was a positive association between DR severity and age (Spearman's rho = 0.4869, p < 0.0001), years since DM diagnosis (Spearman's rho = 0.6877, p < 0.0001), HbA1clevels (Spearman's rho = 0.6315, p < 0.0001), history of hypertension (2.47 1.37 vs. 0.50 0.80 for patients without hypertension; p < 0.0001) and male sex (2.56 1.41 vs. 2.05 1.45 for female patients; p = 0.045, MWW). All these factors, except for age, retained their statistical significance at the multivariate ordinal logistic model. Conclusions. Years since DM diagnosis, hypertension, HbA1clevels and male sex are independently associated with severe DR. The effect of age seems to reflect a confounding association. © 2010 Chatziralli et al; licensee BioMed Central Ltd. Source

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